80 Year Old Female with a Large Growing Goiter

The patient today is an 80 year old female with a large growing goiter. She was told to have surgery. The biopsy was negative for cancer. The goiter was causing some obstructive symptoms. She returned today 2 years after she refused surgery, and elected to be treated with off label thyrogen to boost the thyroid uptake, which was low in her case. The uptake increased to 45% after thyrogen and I treated her with 30 Millicuries of Iodine/131. She has been symptom free and her goiter had decreased to the point it was not visible from across the room, as it had been 2 years ago. The use of Radioiodine therapy, with a boost in the thyroid uptake with thyrogen has allowed me to treat patients with this less invasive therapy, compared to standard thyroid surgery.